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AHI of 2 -- Good Enough? - ShoshTrvls - 09-07-2018
All -
First, no sleepyhead data charts because I have a Z1 Auto and a Mac.
My sleep test found an AHI of 16.6, with the majority (vast) of events while sleeping on my left side, which is my most common sleeping position. My initial prescription suggested a pressure range of 5 - 20. Within 2 nights I knew that would not work -- I was gulping in air, my stomach was distended, and I had trouble exhaling (having been a smoker for many years, I probably have undiagnosed early stage COPD).
So, I reset 5 - 10. Overnight, the pressure generally hovered around 6, but it would on occasion spike up. But, I could only sleep on my left side, and would wake up if I turned onto my back or right side. Still, I had consistent AHI under 5 and was even able to achieve an AHI of 0 on many nights.
For the past week, because I'm tired of being stuck sleeping on my left side and waking up, I set the pressure at 3 - 6. My average pressure has been 5.2, but I do hit the 6 frequently and stay there. But, I've also had a consistent AHI of 2.
My question is ... is there any reason I should still be grasping for that golden ring of 0 AHI, or should I be happy sleeping through the night with an AHI of 2?
RE: AHI of 2 -- Good Enough? - mesenteria - 09-07-2018
Probably much ado about squat in favour of getting that often-elusive 'rested' feeling. That is to say, the science says anything under 5 is pretty darned solid, your AHI of generally 2 is rather excellent. The point, according to the experts here, is...………………………..how do you feel when you awaken and then go about your daily business? If it's good, then you are doing well.
RE: AHI of 2 -- Good Enough? - PaulaO2 - 09-07-2018
Yep. Anything less than 5 is the "golden" goal. But the overall question is how do you feel?
Why are you waking up when you roll onto your back or other side? Is it related to the CPAP or something else?
When making pressure changes, do it slowly. Especially since you have no data to back up your theories.
And, because I know others will suggest it, consider getting another (better?) machine that is data capable. Especially if you are doing this on your own. You can find them on Craigslist (just get from non-smoker due to damage inside the machine) or from Supplier #2 in our Supplier's List.
As a side note, with my pressure at 15-20, your pressure max of 6 is making me feel suffocated!
RE: AHI of 2 -- Good Enough? - ShoshTrvls - 09-07-2018
Thanks to both of you.
First, yes, I know I should get a more robust machine. I guess I'm somewhat paralyzed by indecision - I travel frequently so starting with the Z1 made the most sense, as it was both affordable (I'm paying out of pocket) and portable. Now that I know that (a) I've been able to adapt to sleeping with a mask fairly easily and (b) it is working for me (yes, I'm feeling 110% more restful in the morning), I'm looking at options -- mostly I'm looking at the Dreamstation, but somewhere in the back of my head I fear I may really need a bi-level, which is way out of my price range.
As for why I wake up in other sleeping positions, it is because I can't seem to take in enough air when I'm on my back or right side. I wake up with chipmunk cheeks and a full stomach of air due to aerophagia -- something that doesn't happen when I'm on my left side. Go figure! (This reduced ability to take in air is probably why I've always slept primarily on my left side, even before CPAP therapy).
RE: AHI of 2 -- Good Enough? - PaulaO2 - 09-07-2018
Raise the head of your bed. It will help with the air in the belly thing. You can stick a few planks under there or get thingies that are specifically made for raising beds. You can also put something between the frame and the mattress. They make things for that, too. Another option is to get two pillows and put them like a capital T then lay on the vertical part. The horizontal pillow will raise your head. It will take some fiddling.
The difference between bilevel machines and CPAP/APAP is it allows for greater exhale relief (the other PAPs only allow up to 3cmH2O between inhale and exhale) and it can go higher than 20. Does the Z1 have exhale relief? If so, fiddle with that, too, to see if it helps.
Obstructive events increase when on our backs because of gravity. Raising the head of the bed will help fight gravity.
RE: AHI of 2 -- Good Enough? - ShoshTrvls - 09-07-2018
Thanks for the suggestion on the bed -- in fact, I have a fancy shmancy bed that adjusts but have always put the bed back to flat when sleeping (as opposed to sitting up to read). So, I will give that a try.
The Z1 does have pressure relief but, as you note, the highest setting is 3 (which is what I'm on).
RE: AHI of 2 -- Good Enough? - Sleeprider - 09-07-2018
If you ever want to upgrade, Supplier #2 has Resmed Aircurve 10 Vauto machines ("gently used") at $799. In terms of treating UARS, which I think is your problem, a bilevel can't be beat, and this one is affordable. I'll leave you with a link to a good wiki article on Apnea board that explains my rationale. This machine can provide full data and meet every possible need you have.
http://www.apneaboard.com/wiki/index.php?title=Flow_Limitation/UARS_and_BiPAP
If we had some data, we could dial you into the lowest possible pressure and resolve the remaining issues you feel. I think with the Aircurve 10 Vauto as your primary home machine, you will feel exceptional results and might decide the travel machine may not be worth giving up the comfort, effectiveness and quietness of this one.
RE: AHI of 2 -- Good Enough? - PaulaO2 - 09-07-2018
(09-07-2018, 04:15 PM)ShoshTrvls Wrote: Thanks for the suggestion on the bed -- in fact, I have a fancy shmancy bed that adjusts but have always put the bed back to flat when sleeping (as opposed to sitting up to read). So, I will give that a try.
The Z1 does have pressure relief but, as you note, the highest setting is 3 (which is what I'm on).
Don't go up too high. What determines "too high" is for you. You want to sleep, but you don't want your mouth to fall open.
Try reducing the pressure relief, then. Try 2.
RE: AHI of 2 -- Good Enough? - ShoshTrvls - 09-08-2018
Again, thanks for the wisdom.
I went ahead and purchased a "gently used" Dreamstation Auto CPAP (the Vauto looked too daunting!) from Supplier #2. I'll give it a whirl, start using sleepyhead (there is a Mac version, yes?), and be back at ya if I have any further issues.
RE: AHI of 2 -- Good Enough? - Sleeprider - 09-08-2018
I would have rather seen you get the Resmed S9 Autoset gently used instead because of the way it handles exhale pressure relief. If you can still swap, do it. The Respironics will give you good APAP therapy and full data, It is much less responsive to flow limitation and the Flex pressure relief is a bit tricky to dial in for many people.